Chronic pain is one of the most common long-term conditions in Aotearoa (New Zealand), and there is a higher prevalence and greater impact of pain for Māori (Indigenous People of New Zealand). Māori tend to have a more holistic interpretation of pain compared with western views; therefore, current assessments may not capture the full meaning and impact of pain for Māori. This study developed a holistic assessment tool for chronic pain in collaboration with Māori clinicians and Māori with chronic pain. The Pictorial Representation of Illness and Self Measure–Aotearoa (PRISM-A) is a verbal and visual assessment tool that is based on Te Ao Māori (Māori world), imbeds whakawhanaungatanga (relationship formation) between the patient and clinician, and incorporates Te Whare Tapa Whā, a Māori model of health. The tool is likely to provide a more meaningful assessment of pain and facilitate better outcomes for Māori with chronic pain.